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To what extent carotid stenosis requires surgery

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Carotid stenosis is a hidden killer that modern people can not ignore. However, some patients neglect treatment because they do not understand the disease. The stenosis of carotid artery is mostly in middle and old age. Therefore, friends over 50 years of age have regular physical examination for carotid artery color Doppler ultrasonography, so as to be able to find and treat early and avoid the occurrence of carotid artery stenosis. Below, Xiaobian will give you a detailed introduction of the treatment of carotid artery stenosis.

In addition to drugs, carotid artery stenosis is mainly dependent on carotid artery stripping and stent intervention. In fact, the extent to which carotid artery stenosis needs surgical treatment has always been a difficult point in clinical decision-making. The European and American countries have known and studied carotid stenosis earlier than we did. They reported carotid endarterectomy for carotid stenosis with carotid endarterectomy in the 50s of last century, and have done several large clinical trials.

The results showed that the stenosis rate of carotid artery was more than 70% compared with that of taking aspirin, that is, when the stenosis was severe, it was necessary to do exfoliation; and when the stenosis rate was 50% to 69%, the effect of exfoliation was about 5 years later. This means that the operation should be considered carefully for the elderly patients; it is less than 50% of the stenosis, The effect of exfoliation is not as good as drug. These conclusions are from a large medical center (more than 25 cases of surgery per year). The incidence of complications in symptomatic patients is less than 6%, while the incidence of complications in asymptomatic patients is less than 3%.

All patients with artery stenosis accounting for 50% to 70% and symptomatic and narrow >70% should be treated with surgery.

Traditional surgery (carotid endarterectomy CEA) CEA is the standard method for the treatment of carotid artery stenosis, but it has been gradually replaced by interventional therapy because of the large trauma.

Interventional therapy (CAS) is the purpose of ensuring the smooth blood flow of the carotid artery by placing the stent in the stenosis segment of the carotid artery and expanding the carotid artery. Its advantages are minimally invasive, quick recovery and shorter hospitalization time. The indications were: elderly patients with severe cardiovascular disease, severe stenosis of surgical approach (high stenosis), restenosis after radiotherapy, restenosis after CEA and intercalated stenosis, etc.

The carotid artery blockade technique (MOMA) has a greater risk of plaque loss due to severe carotid stenosis, so a new carotid artery blockage technique can be used. Its disadvantage is that the cost of treatment is about 3 times more than CEA.

Warm hints: the patients with carotid artery stenosis should pay attention to the balanced diet, eat more high fiber foods such as fruits and vegetables, eat more high protein foods such as eggs, soybeans and so on, and pay attention to the light diet and exercise a proper amount of exercise. Usually, it is better to avoid smoking, drinking, spicy, coffee and other stimulating foods, so as not to aggravate the illness due to improper diet.


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